What are the most effective strategies for coping with the stress of infertility?

Psychological coping strategies associated with improved mental health in the context of infertility

By Andie Chernoff, BSc

Infertility can be an overwhelmingly painful experience that has been linked to high rates of depression and anxiety. It can be hard to know how to cope – and, in fact, even psychologists don’t have a clear understanding of what coping strategies are most effective for individuals struggling with infertility because the research on this topic is unclear. So we aimed to shed some light on this issue by looking at the relationship between daily coping strategies and mood in women struggling to conceive naturally. Specifically, sixty-five women who had been struggling to conceive for one year or more were followed across one menstrual cycle and asked to rate their mood and to report on their coping strategies every three days. We then looked at which coping strategies were related to the best emotional state.

What we found was that women experienced less depression, anxiety, and infertility-related distress when they engaged in activities aimed at distracting them from trying to get pregnant and aimed at helping them relax. This finding is in line with previous research suggesting that focusing on self-fulfilment in areas outside of pregnancy achievement is beneficial for mood in women preparing for, or undergoing, fertility treatments.

However, diverting attention away from one’s infertility struggles is not only easier said than done, but can also be associated with negative outcomes when taken to the extreme. That is, our results also suggested that trying to downplay the importance of conceiving – telling yourself “whatever, I don’t care if I get pregnant or not” when that clearly isn’t the case, is associated with more depressive mood. So complete avoidance of the negative feelings associated with infertility is unhelpful; instead, it’s important to acknowledge and accept one’s feelings but not to allow those feelings to stop you from engaging in life. When a woman is feeling sad or anxious about her infertility, our findings suggest that it’s best to try and practice self-care by engaging in activities that bring pleasure – catching a movie, going for a run, enjoying a night out with friends. These activities obviously won’t take the pain of infertility away but they at least result in temporary improvements in mood and anxiety.

Contrary to what we expected, talking about one’s infertility with loved ones was associated with more, rather than less, distress in our participants. One potential explanation may be that women tend to seek social support when they’re more stressed about their infertility. However, another explanation may be that women’s attempts to open up about their infertility are often met with unhelpful comments that make them feel worse rather than better. Comments like “don’t worry, it’ll happen one day” or “there’s always adoption” are intended to be reassuring but may result in a woman feeling that her pain is being minimized. Perhaps interventions aimed at educating loved ones on how to best support people experiencing infertility could improve the quality of the support that women receive (e.g. see our blog post on “Five things not to say to someone struggling with infertility”).

If you’re a woman who’s struggling with depression or anxiety related to infertility, it might be helpful to think: “how do I tend to cope when I’m feeling my worst?”. Do you tend to withdraw from life? If so, that’s ok and totally understandable, but you might want to limit how long you allow yourself to do that. So absolutely stay home in your PJs and wallow every once in awhile but try not to do that too often or for too long because odds are, you’ll feel better if you push yourself to get back out there. Or are you someone who tends to keep a stiff upper lip and deny any feelings of pain or disappointment? If so, it might be helpful to work towards exploring and acknowledging your feelings – journaling or practicing mindfulness meditation could be helpful strategies for doing that.